MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC (NPI# 1750374575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750374575 |
| Entity Type | Organization |
| Organization Name | MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC |
| Practice Address |
410 Dewey St Wisconsin Rapids WI 54494-4715 |
| Mailing Address |
Po Box 8075 Wisconsin Rapids WI 54495-8075 |
| Practice Telephone | 7154215257 |
| Practice Fax Number | 7154210111 |
| Mailing Telephone | 7154215255 |
| Mailing Fax Number | 7154210111 |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2010-08-06 |
| Authorized Official Name | MR. WAYNE R CHRISTIE (VICE PRESIDENT) |
| Authorized Official Telephone | 7154215257 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32685600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609958404 | Mcdonough Orthopaedic and Sports Medicine Center Sc | Durable Medical Equipment & Medical Supplies | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2006-10-20 |
| 1073506838 | Mcdonough Orthopaedic and Sports Medicine Center Sc | Prosthetic/Orthotic Supplier | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2005-08-26 |
| 1609869460 | Mcdonough Orthopaedic and Sports Medicine Center Sc | Podiatrist | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2005-08-26 |
| Street Address |
410 DEWEY ST |
| City | WISCONSIN RAPIDS |
| State | WI |
| Zip Code | 54494-4715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457968687 | Bradley Richard Brossard | Nurse Practitioner | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2020-10-01 |
| 1801449541 | Jatra LLC | Clinic/Center | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2019-07-22 |
| 1578121828 | Kelly Ann Brusky | Physician Assistant | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2019-06-02 |
| 1902379613 | Karron Leigh Cohoon | Nurse Practitioner | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2019-01-04 |
| 1306312319 | Krista Ann Hafenbredl | Nurse Practitioner | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2018-10-17 |
| 1659856375 | Rebecca Anne Fetterer | Nurse Practitioner | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2018-09-27 |
| 1942725676 | Christine Feder | Nurse Practitioner | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2017-08-03 |
| 1447798400 | Aspirus Riverview Hospital & Clinics, Inc. | General Acute Care Hospital | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2017-02-09 |
| 1215480421 | Florence Tavera Neilitz | Physician Assistant | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2016-07-25 |
| 1255723375 | Coast To Coast Wisconsin LLC | Emergency Medicine | 410 Dewey St, Wisconsin Rapids, WI 54494-4715 | 2015-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114556057 | Danny Thomas O'day | Massage Therapist | 2841 Saratoga St., Wisconsin Rapids, WI 54494 | 2020-04-03 |
| 1588184584 | Debra Lee Eberhardy | Acupuncturist | 400 Daly Avenue, Suite 101, Wisconsin Rapids, WI 54494 | 2017-06-21 |
| 1235687716 | Jessica Lynn Noah | Marriage & Family Therapist | 3930 8th St. So., Ste 101, Wisconsin Rapids, WI 54494 | 2016-09-14 |
| 1700332079 | Tammy Marie Fischer | Social Worker | 3908 8th Street South, Suite 101, Wisconsin Rapids, WI 54494 | 2016-08-28 |
| 1720447675 | Marita Lynn Verhalen | Occupational Therapist | 410 Dewey St, Wisconsin Rapids, WI 54494 | 2016-02-21 |
| 1346656469 | Lori Kroening | Counselor | 2509 8th Street S, Wisconsin Rapids, WI 54494 | 2014-07-09 |
| 1104166305 | Shannon Colleen Huff | Psychologist | 531 3rd St S, Wisconsin Rapids, WI 54494 | 2013-02-25 |
| 1245589787 | Jennifer J Derousseau | Social Worker | 2611 12th Street South, Wisconsin Rapids, WI 54494 | 2012-08-30 |
| 1922200575 | Thomas Harrison Raabe | Optometrist | 132 East Grand Ave, Wisconsin Rapids, WI 54494 | 2007-06-05 |
| 1508901067 | Michael J Downs | Optometrist | 1730 7th St S, Wisconsin Rapids, WI 54494 | 2007-02-21 |
| Find all providers in zip 54494 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538300306 | Roberts and Associates Physical Therapy | Clinic/Center | 1210 Pepper Ave, Wisconsin Rapids, WI 54494-6415 | 2009-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313074 | Byond Physical Therapy, LLC | Clinic/Center | 11320 W Forest Home Ave, Franklin, WI 53132-1401 | 2020-10-13 |
| 1568078780 | Streamline Physical Therapy | Clinic/Center | 5806 Crabapple Ln, Madison, WI 53711-3437 | 2020-09-22 |
| 1790311199 | Exos Wi LLC | Clinic/Center | 7044 S Ballpark Dr Ste 300, Franklin, WI 53132-6910 | 2020-03-17 |
| 1831735885 | Garvey Physical Therapy & Wellness LLC | Clinic/Center | 417 Maple Ct, Campbellsport, WI 53010-3531 | 2019-11-25 |
| 1821649088 | Impact Physical Therapy & Performance LLC | Clinic/Center | 1155 Clarity Dr, Verona, WI 53593-9318 | 2019-09-27 |
| 1427605146 | Peak Endurance | Clinic/Center | 15 N Butler St, Madison, WI 53703-4237 | 2019-08-19 |
| 1558917617 | Quad/med, LLC | Clinic/Center | N61 W23044 Harry's Way, Sussex, WI 53089 | 2019-08-14 |
| 1619521267 | Space To Be Well, LLC | Clinic/Center | 1091 Sutherland Ave, River Falls, WI 54022-7509 | 2019-07-31 |
| 1346894656 | Cornerstone Physical Therapy, LLC | Clinic/Center | 2829 County Highway I Ste 3, Chippewa Falls, WI 54729-2678 | 2019-07-25 |
| 1619437514 | Resilience Rx LLC | Clinic/Center | 4708 Graywood Ct Apt 3, Nashotah, WI 53058-9688 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
| City | WISCONSIN RAPIDS |
| Zip Code | 54494 |
Please comment or provide details below to improve the information on MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.